A Comparative Study of Early Versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis and its Associated Complication
Journal Title: New Indian Journal of Surgery - Year 2019, Vol 10, Issue 2
Abstract
Context: Acute cholecystitis is a common surgical problem and was usually treated with conservative management followed by a delayed laparoscopic cholecystectomy after an interval of 6 to 8 weeks. Our aim was. Aims: To compare the efficacy of Early laparoscopic Cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) in patients of acute cholecystitis, and also to assess the complications between the two. Settings and Design: This study was a prospective randomized controlled trial in Vydehi Institute of Medical Sciences and Research Centre from January 2015 to June 2016 that was conducted on 50 consecutive patients diagnosed to have acute cholecystitis. Methods and Material: 25 patients underwent immediate laparoscopic cholecystectomy within 24-72 hours of admission and 25 patients underwent a delayed laparoscopic cholecystectomy after 6-8 weeks of the initial episode. Parameters related to surgery, complications and postoperative period were observed, tabulated and analysed. Statistical analysis used: The demographic variables were represented in percentage and continuous variables were represented using Mean and Standard Deviation. Possible associations were found out using chi-square test / Fisher exact test. Results: In the early surgery group, intraoperative complications noted were adhesions (16%), bleeding (16%), GB perforation (8%) and bile duct injury (4%). In late surgery group, complications that were noted were adhesions (68%), bleeding (40%), and GB perforation (12%), bile duct (12%) injury. Postoperatively, complications seen in early surgery were bile leak (4%), bile leak (4%) and postoperative jaundice (4%) which included SSI for 2 patients. In late surgery, postoperative complications seen were bile leak (16%) and jaundice (12%), again not statistically significant. Duration of surgery in ELC patients was statistically higher at 76.16 ± 23.38 minutes than that in LLC group which was 116.48 ± 23.14 minutes. Mean hospital stay was more in LLC when compared with ELC (6.48 days vs 3.84 days). Conclusions: Early laparoscopic surgery had similar intraoperative and postoperative complications compared to delayed surgery in acute cholecystitis, but was associated with a shorter surgery and lesser stay in the hospital.
Authors and Affiliations
Ravi Kumar
Keywords
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- EP ID EP594357
- DOI 10.21088/nijs.0976.4747.10219.13
- Views 81
- Downloads 0
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